Intragastric Maldistribution of a Liquid Meal in Children with Recurrent Abdominal Pain Assessed by Three-Dimensional Ultrasonography

• Published in: Scandinavian journal of gastroenterology 2003-08, Vol.38 (8), p.819-825
• Main Authors: OLAFSDOTTIR, E, GILJA, O. H, TEFERA, S, FLUGE, G, BERSTAD, A
• Format: Article
• Language: English
• Subjects: Abdominal Pain - diagnostic imaging; Abdominal Pain - etiology; Abdominal Pain - physiopathology; Adolescent; Biological and medical sciences; Child; Digestive system. Abdomen; Dyspepsia; Female; Food; Gastric Accommodation; Gastrointestinal Contents; Gastrointestinal Motility - physiology; Humans; Image Processing, Computer-Assisted - methods; Imaging, Three-Dimensional - methods; Intragastric Distribution; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Pain Measurement; Postprandial Period - physiology; Recurrence; Recurrent Abdominal Pain; Stomach - diagnostic imaging; Stomach - physiopathology; Three-dimensional Ultrasonography; Ultrasonic investigative techniques; Ultrasonography; Ultrasound
• ISSN: 0036-5521; 1502-7708
• DOI: 10.1080/00365520310003480

Background: Using two-dimensional (2D) ultrasonography, we previously found indications of impaired adaptive relaxation of the proximal stomach in children with recurrent abdominal pain (RAP). In the present study, we applied a new three-dimensional (3D) ultrasonographic method to investigate intragastric volumes and distribution of a liquid meal in another group of children with RAP. Methods: Twenty patients with RAP (age 10-15 years) and 20 healthy subjects (age 11-15 years) underwent ultrasonographic measurements of the stomach. A position sensor was used based on magnetic scanhead tracking for acquisition of 3D images after a liquid meal. The children scored abdominal symptoms before and after the meal. Results: Expressed as a fraction of ingested volume, the patients had a smaller volume of the proximal stomach and a larger antral volume at 2 &#114 min postprandially compared to healthy subjects ( P &#114 = &#114 0.03 and P &#114 = &#114 0.001, respectively). The patients also showed a decreased proximal to distal gastric volume ratio at 2 &#114 min postprandially ( P &#114 = &#114 0.001). Patients experienced more pain in response to the meal than healthy subjects ( P &#114 = &#114 0.04), but there was no correlation between pain and proximal or distal gastric volumes. Conclusions: RAP in children may be associated with an early intragastric maldistribution of a meal.